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A Scoping Review of Validated Tools to Measure Incivility in Healthcare Settings

Harris, Whitney C. MSN, RN, ACCNS-P, CPNP-PC; Usseglio, John MPH; Chapman-Rodriguez, Rose MS, RN, CPNP-PC, CCTC; Licursi, Maureen MSN, RN, CPNP-PC; Larson, Elaine PhD, RN, FAAN

JONA: The Journal of Nursing Administration: September 2019 - Volume 49 - Issue 9 - p 447–453
doi: 10.1097/NNA.0000000000000783

OBJECTIVE To identify and compare validated tools used to assess incivility in healthcare settings.

BACKGROUND Incivility in the workforce is associated with poor quality outcomes, increased employee turnover, and decreased job satisfaction. Validated tools are essential for accurate measurement of incivility. The aim of this study was to compare characteristics of validated tools for use in a busy clinical setting.

METHODS In a scoping review, English language research studies using incivility tools published in PubMed or CINAHL between March 1, 2013, and March 14, 2018, were assessed for sound psychometric properties and feasibility of use (eg, short, easy to administer).

RESULTS After screening 869 articles and full text review of 244, 5 identified tools met the criteria; the Short Negative Acts Questionnaire seemed best suited for use in a busy healthcare setting.

CONCLUSION Adoption of a standardized and validated incivility tool makes it possible to compare across clinical settings and track progress over time.

Author Affiliations: Clinical Nurse Specialist of the Pediatric Intensive Care Unit (Ms Harris), Program Director of Nurse Practitioners (Ms Chapman-Rodriguez), and Pediatric Nurse Practitioner of the Pediatric Hematology, Oncology and Stem Cell Transplant Center, Pediatric Cancer and Blood Disorders (Ms Licursi), Morgan Stanley Children's Hospital of New York Presbyterian; Senior Associate Dean for Research and Anna C. Maxwell Professor of Nursing Research (Dr Larson), School of Nursing Professor of Epidemiology, Mailman School of Public Health Columbia University, Columbia University School of Nursing; and Informaticist (Mr Usseglio), Augustus C. Long Health Sciences Library, Columbia University Irving Long Medical Center, New York.

The authors declare no conflicts of interest.

Correspondence: Ms Harris, Morgan Stanley Children's Hospital of New York Presbyterian, 3959 Broadway Ave, New York, NY 10032 (

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